Field Reimbursement Manager
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Job Description
Field Reimbursement Manager supporting reimbursement, payer education, and patient services for McKesson’s healthcare products. Serving Long Island physician offices and manufacturer representatives through field-based education and case support.
Responsibilities:
- Manage an assigned territory supporting reimbursement and patient services for a specific drug
- Assist with Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals
- Educate physician offices on payer landscape and available services through remote interactions and on-site training
- Build relationships with physician offices and manufacturer representatives
- Collaborate with internal program hub support services to meet customer needs
- Arrange site visits, manufacturer trainings, and educational training venues by telephone
- Provide on-site and on-demand education, including Lunch and Learns or Dinner presentations
- Deliver reimbursement education and support through approximately 15 on-site/virtual interactions per week
- Record activities in the FRM CRM daily and report to the manager weekly
- Educate on Benefit Investigation, Prior Authorization, Support Center Services, Medicare and Commercial coverage, and patient communication streams
- Provide reimbursement support for case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, co-pay assistance, and patient assistance programs
- Collaborate with case managers on approximately four cases per month and handle escalations as needed
- Set appointments, complete outbound calls to targeted offices, and assist with backlog casework
- Interface with physicians and manufacturer representatives to exchange patient- and provider-specific information
- Monitor physician and manufacturer representative program performance using FRM CRM dashboards and quarterly reporting
- Research and compile provider/manufacturer representative information and create facility databases in FRM CRM
Requirements:
- Candidate must live within the Long Island, NY area
- 4-year degree in related field or equivalent experience
- 4+ years of healthcare related reimbursement experience
- Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
- Experience supporting oncology products preferred
- Experience in the healthcare industry including insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
- Must have Medicare and commercial insurance coverage experience
- Must be able to deliver and document benefit investigation outcomes and relay status reports regularly
- Proven presentation skills and experience
- Ability to effectively handle multiple priorities and excellent organizational skills
- Strong computer literacy, including PowerPoint and web meeting experience
- Previous field experience, specialty pharmacy experience, and account management experience are a plus
- Excellent interpersonal skills
- Excellent written and oral communication skills
- Problem-solving and decision-making skills
- Must reside in the Long Island, NY territory
- Must be able to travel 80% (4 days a week) via automobile or plane
- Must have a valid driver's license with a clean driving record/MVR
Benefits:
- Competitive compensation package
- Annual bonus may be offered
- Long-term incentive opportunities may be offered
- Equal employment opportunities
- Reasonable accommodation for job search or application
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